SIGNS OF CHRONIC LIVER DISEASE (

Words in bold italic font are signs of decompensation)

Skin

Slate grey pigmentation (haemochromatosis)

Purpura
(bleeding)

Scratch marks (itch)

Tattoos (viral hepatitis)

Needle track marks (viral hepatitis)

Hair

Paucity of body hair and inverted pubic hair distribution

Eye

Jaundice

Pallor (anaemia)

Xanthelasmas (PBC)

Kayser-Fleischer ring (Wilsons)

Tongue

Cyanosis (pulmonary venous shunts)

Nails

Clubbing


Leuconychia

Koilonychia (iron deficiency from blood loss)

Hands

Dupuytrens contracture (alcohol)

Palmar erythema

Flapping tremors
(encephalopathy)
Limbs

Muscle wasting
Neck

Parotid enlargement (alcohol)

Hypothyroidism (autoimmune hepatitis)

Chest

Gynaecomastia

Signs of obstructive airway disease (

-1 antitrypsin deficiency)
Abdomen

Hepatomegaly (alcohol, acute inflammation)

Splenomegaly (portal hypertension)

Ascites

Caput medusa (portal hypertension)

Back

Spider naevi
Genital

Testicular atrophy